An Advocate’s Take on Why We Need To Do More For Women with Postpartum Psychosis

I wrote about the Otty Sanchez plea bargain on Tuesday. Then I received the following from Postpartum Progress reader Hajara Kutty. Hajara is a coordinator in Ontario for Postpartum Support International. Read her opinion about postpartum psychosis and how the postpartum community needs to do more to help these mothers. What do you think?

Otty, Scotty & Me

Where most postpartum advocates are celebrating the Otty Sanchez decision, for me the verdict is bittersweet. This is not to say that those celebrating are without just cause. It's quite the opposite. We have every reason to rejoice; a woman who committed infanticide while suffering from postpartum psychosis has been spared the death sentence.

However, I just can't get over that instead of facing the chair, Otty will lose the bulk of her remaining life (if not all of it) to a maximum-security mental institution. And this because of what? Some would argue that it is because of her unspeakable crime of savagely killing and mutilating her baby, Scotty, of only a few weeks. But this, as determined by the courts, was not her fault as she was insane at the time. Add to this the court's acknowledgment that Otty had tried to get help for herself.

This, for me, is why the verdict is bittersweet: sweet because she has been spared a lengthy trial and potential death sentence. It's bitter, however, not only because she was failed by those around her, but because her case casts a glaring light on the work we, as a postpartum community, have failed to do.

Compared to all other infanticides, perhaps what strikes me most about this case in particular is how Otty demonstrated a great deal of sanity despite her insanity.

For one, Otty had a history of mental illness that she was open about. In the aftermath of the tragedy even distant relatives emerged to reveal that Otty had been in and out of psychiatric hospitals for years. Her husband, Scott, famous for calling for Otty to get the death sentence, divulged that Otty had told him she was schizophrenic the week before the incident.

In a world more informed about postpartum psychosis, this should have sounded alarm bells, since having a pre-existing mental illness, especially bipolar disorder or schizophrenia, puts women at a seriously increased risk of developing postpartum psychosis.

Next, Otty was agitated on the night before the tragedy and wasn't trying to hide how disturbed she was. She was reported to have brought her son over and over again to her sister throughout the night. The sister, in turn, spent much of the night caring for the infant. Mere hours after handing him back to Otty he was dead.

Again, in a world more informed about postpartum psychosis, this behavior could have at least resulted in Otty being taken to an emergency room.

For me, point number three is the most important and saddening: Otty told people she was hearing voices. In fact, this is what landed her in an emergency room hours after giving birth. Despite exhibiting this obvious symptoms of postpartum psychosis so soon after giving birth, Otty was sent home. Though some reports say that she was prescribed the antidepressant citalopram for her symptoms, there is no mention whatsoever about hospitalization, antipsychotic medication or 24-hour supervision — steps that could have prevented the tragedy that followed.

All of this is what essentially leads me to the bitter realization that we, as a postpartum community, need to wake up to the reality of this illness.

We need to stop apologizing for this condition and wasting precious time and space reassuring people that this is a rare phenomenon. Instead, we need to put out important, relevant information including: that bipolar disorder and schizophrenia are serious risk factors for postpartum psychosis; that symptoms like agitation, severe insomnia or bizarre behavior/speech in the postpartum period may be symptoms of postpartum psychosis and need to be checked out immediately; that women suspected of suffering from or those diagnosed with this condition need to be supervised 24/7 until stable; and that postpartum psychosis is easily treatable.

Putting out this kind of information is what is going to help families to get their loved ones help, even in the face of ignorant healthcare professionals, and in the end, is what will prevent postpartum tragedies from occurring.

I truly believe that we, who are passionate about postpartum issues or work in the field, need to be actively putting out the right kind of information about this illness. And by doing that, I feel confident that we can ensure that Scotty and Otty (and all the other mothers) will have not lost their lives in vain.

Katherine Stone is the creator of this blog, and the founder and executive director of Postpartum Progress. She has been named a WebMD Health Hero, one of the fiercest women in America by More magazine, and one of the 15 most influential patient advocates to follow. She is a survivor of postpartum OCD.

Comments

Thank you, thank you, thank you. I'm blessed (or a lucky sonofabitch, depending on how you look at it) to have a specialized psychiatrist that saw these symptoms & immediately told my family what to do. & then had a specialized hospital floor & treatment facility that I could be admitted into. What is bittersweet to me, coming on the other side of going through psychosis – what about a woman who isn't bipolar or schizophrenic, but simply has postpartum psychosis on it's own? Eventually, she will find clarity with the right medication & therapy. She was insane AT THE TIME. She may not remain insane for the remainder of her life. Should she be locked up forever in a max. security mental hospital for the rest of her days? Or is jail the best place once she's clear? Or should she be downgraded? At what point does she keep paying for the price of temporary insanity, even though she has clarity & agony over her actions later? But she killed her child, & that is an unthinkable action, even while insane. Insanity cannot be an excuse for taking a life. But is it an excuse when there were no resources or support? Is that a case of ignorance above the law, or law above ignorance of society? This is something I struggle with. I know that's an unpopular opinion.

Thank you for this post! I completely agree, we all need to be aware of the symptoms of postpartum psychosis. Fortunately, in my case, I was admitted to hospital one week postpartum and monitored until I was healthy enough to go home again. It was a brief (6 wk), intense period of struggle that has been followed by three years of good mental health. And my healthy, wonderful, 3yo daughter was totally worth it!

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Postpartum Progress exists to provide peer-to-peer support. The information on this site is for educational, advocacy purposes only. It is not intended to diagnose or treat any medical or psychological condition. Please consult your own health care provider for individual advice regarding your specific situation and needs.